01.6 - Da Form 2 · 132007.616.05

PART 7 — FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT
MANAGER

xisting building use/classification? (if applicable)

  

 

New building use/classification? |
| Site area (m2) [ 531

 

 

| Floor area (m2) | 0

 

 

 

Confirm proposed construction materials:

External walls

 

Frame

 

Floor

 

Roof covering

Date received: | | Reference numbers: | |

 

 
     

Classification(s) of approved building work QBCC Insurance receipt QBCC Certification Licence

number number

[ia & 10a |

Mc I

 

Prescribed assessment manager

 

Name of chosen assessment manager

 

Date chosen assessment manager engaged

Contact number of chosen assessment manager

Relevant licence number(s) of chosen assessment
manager

 

 

 

 

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required development application materials should
be sent to the assessment manager.

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NA Farm 2 — Nevelanmant Annlicatian dataile